| Regimental number | 13357 |
| Place of birth | Warragul Victoria |
| Religion | Church of England |
| Occupation | Grocer |
| Address | Traralgon, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs M Stephens, Railway Street, Traralgon, Victoria |
| Enlistment date | 5 July 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A63 Karoola on 7 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Field Ambulance |
| Fate | Returned to Australia |
